Introduction to Sexual Disorders
Paraphillias are disorders of deviant sexuality. As defined in the Diagnostic and Statistical Manual of Mental Disorders (the clinician's diagnostic bible), they involve recurrent fantasies, urges or behaviors of a sexual nature that center around children, non-humans (animals, objects, materials), or harming others or one's self.
Because they are so often associated with abusive sexual practices that generate real victims, many people tend to regard persons who display sexual deviancies as monsters. Further, many people tend to assume that all sexual deviants are equivalently awful and repugnant. Neither of these statements are accurate. While they are ultimately responsible for their choices (including those that harm other people), and should be punished and thereafter closely monitored to prevent further abusive practices, even predator child-molesting pedophiliac are legitimately suffering from mental, emotional and spiritual disturbance and should be able to participate in mandated treatment. Whereas pedophilia (child molestation) is a particularly awful sexual deviancy, there are other forms of sexual deviancy such as transvestism and many forms of fetishism that harm no one and that do not deserve to be thought of in the same breath as child molestation.
A list of the paraphillias follows, each with a short description:
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Exhibitionism involves a compulsion to display one's private parts to strangers. Like gamblers, pyromaniacs and other impulse-junkies, exhibitionists cycle through periods of increasing tension that are only relieved by the ‘rush' of exposing themselves to strangers (occasionally accompanied by masturbation).
Fetishism involves having ones sexual energies fixated on to a manufactured object, rather than onto another human being. Frequently, fetish objects are garments such as shoes, underwear, panties or bras. They may be made of particular materials such as leather or rubber. It is common for a person with a fetish to not be able to achieve orgasm without involving their fetish object in the sexual act (e.g., by getting their partner to wear the fetish object). Although not specifically mentioned in the DSM, persons who chronically rely on pornography for sexual arousal probably qualify as fetishists.
Frotteurism involves a compulsion to rub ones self against strangers others in a sexual manner. Like exhibitionism and other impulse control disorders, frotteurism tends to involve a cycle of tension buildup that is relieved by acting out in ‘exciting' ways.
Pedophilia occurs when a sexually mature adult fantasizes about or engages in sexual behavior with pre-pubescent children. Pedophiles tend to have preferences for male or female children (but not both). They may be exclusively child focused, or they may also be interested in adult sexuality. Pedophiles commonly rationalize their deviant behavior (which may include fondling only, or actual child-rape) as being educational and for the child's benefit. They may also believe that their child victim has sexually seduced them. It is fairly common that the pedophile will threaten the child so as to keep their predatory sexual behavior secrete. Because the pedophile often is the parent or step-parent of the victim child, or has worked hard to gain the confidence of the parents, there are often few perceived safe people and places who a child could report their victimization to anyway.
Sexual Masochism and Sadism involves persons who engage in sexual encounters where the focus is on causing (sadism) or receiving (masochism) physical and emotional pain, embarrassment and humiliation.
Transvestism (Transvestic Fetishism) occurs when an otherwise ‘normal' heterosexual male has fantasies about and/or acts out dressing up in woman's clothing. Such cross dressing is commonly experienced as sexually stimulating.
Voyeurism or ‘peeping tom' behavior involves compulsive fantasizing about and/or acting out engaging in spying on someone (who does not know they are being observed) in the act of disrobing. This sort of behavior is very common amongst the general population; it is not diagnosable as a disorder unless it becomes a compulsive part of a person's sexual routine.
As exists in most other categories of disorders, the DSM recognizes a ‘catch-all' Not-Otherwise-Specified form of paraphillia which can be diagnosed when other sexually deviant practices need to be recorded. Examples include chronic preoccupation with making obscene telephone calls, relating sexually to only a part of another's body, dead people, feces and urine, animals and the like.
On a final note, we should point out one mode of sexuality which is definitively not listed here; namely Homosexuality. Although historically listed as a sexual deviancy, homosexuality has been recognized as a completely normal variant of human sexuality for many years now. But just because being gay isn't a sexual deviency or disorder, doesn't mean that it doesn't come with its own set of stressful issues. For more on that topic, please visit our Gay, Lesbian & Bisexuality Resources center.